Healthcare Provider Details
I. General information
NPI: 1104101054
Provider Name (Legal Business Name): SOUTH CAROLINA RESEARCH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2011
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
68 PARKWAY COMMONS WAY
GREER SC
29650-5213
US
IV. Provider business mailing address
68 PARKWAY COMMONS WAY
GREER SC
29650-5213
US
V. Phone/Fax
- Phone: 864-877-5688
- Fax:
- Phone: 864-877-5688
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | 27855 |
| License Number State | SC |
VIII. Authorized Official
Name: DR.
SERGIO
ALFREDO
SANCHEZ
Title or Position: CEO
Credential: M.D.
Phone: 864-877-5688